Type of asthma that can be irreversible due to airway remodeling (sub-basement membrane fibrosis, hypertrophy of bronchial glands, and smooth muscle hyperplasia)

• A. Atopic asthma
• B. Occupational asthma
• C. Non-atopic asthma
• D. Cryptogenic organizing pneumonia

Answer: (B)

Airway remodeling in asthma can progress to fixed, irreversible obstruction when the inflammatory process drives structural changes in the airways. Features like thickening of the subepithelial basement membrane, hypertrophy or hyperplasia of smooth muscle, and enlargement of mucous glands contribute to narrowing that persists despite bronchodilator therapy. When asthma is driven by ongoing exposure in the workplace, as in occupational asthma, these remodeling changes accumulate over time due to chronic irritation and sensitization, making obstruction less reversible and sometimes permanent. In contrast, atopic and non-atopic asthma are broader categories linked to allergic sensitization or other triggers, where obstruction remains more reversible with treatment. Cryptogenic organizing pneumonia is a distinct non-asthma lung condition and does not present as airway remodeling–driven irreversible obstruction.